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EDSS

Multiple sclerosis

EDSS steps 1.0 to 4.5 refer to people with MS who are able to walk without any aid and is based on measures of impairment in eight functional systems (FS):

  • pyramidal - weakness or difficulty moving limbs
  • cerebellar - ataxia, loss of coordination or tremor
  • brainstem - problems with speech, swallowing and nystagmus
  • sensory - numbness or loss of sensations
  • bowel and bladder function
  • visual function
  • cerebral (or mental) functions
  • other
Expanded Disability Status Scale (EDSS)

  • 1.0: No disability, minimal signs in one FS
  • 1.5: No disability, minimal signs in more than one FS
  • 2.0: Minimal disability in one FS
  • 2.5: Mild disability in one FS or minimal disability in two FS
  • 3.0: Moderate disability in one FS, or mild disability in three or four FS. No impairment to walking
  • 3.5: Moderate disability in one FS and more than minimal disability in several others. No impairment to walking
  • 4.0: Significant disability but self-sufficient and up and about some 12 hours a day. Able to walk without aid or rest for 500m
  • 4.5: Significant disability but up and about much of the day, able to work a full day, may otherwise have some limitation of full activity or require minimal assistance. Able to walk without aid or rest for 300m
  • 5.0: Disability severe enough to impair full daily activities and ability to work a full day without special provisions. Able to walk without aid or rest for 200m
  • 5.5: Disability severe enough to preclude full daily activities. Able to walk without aid or rest for 100m
  • 6.0: Requires a walking aid - cane, crutch, etc - to walk about 100m with or without resting
  • 6.5: Requires two walking aids - pair of canes, crutches, etc - to walk about 20m without resting
  • 7.0: Unable to walk beyond approximately 5m even with aid. Essentially restricted to wheelchair; though wheels self in standard wheelchair and transfers alone. Up and about in wheelchair some 12 hours a day
  • 7.5: Unable to take more than a few steps. Restricted to wheelchair and may need aid in transfering. Can wheel self but can not carry on in standard wheelchair for a full day and may require a motorised wheelchair
  • 8.0: Essentially restricted to bed or chair or pushed in wheelchair. May be out of bed itself much of the day. Retains many self-care functions. Generally has effective use of arms
  • 8.5: Essentially restricted to bed much of day. Has some effective use of arms retains some self care functions
  • 9.0: Confined to bed. Can still communicate and eat
  • 9.5: Confined to bed and totally dependent. Unable to communicate effectively or eat/swallow
  • 10.0: Death due to MS
Reference




Sources: Kurtzke JF.  Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS).  Neurology. 1983 Nov;33(11):1444-52.  


  Haber A, LaRocca NG. eds.  Minimal Record of Disability for multiple sclerosis.  New York: National Multiple  Sclerosis Society; 1985. 

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